The Impact of Rideshare Transportation Services on Appointment Adherence

This study is a prospective clinical trial designed to primarily test the impact of rideshare-based transportation services from a digital transportation network, Lyft, on reducing primary care clinic missed appointments--a composite outcome of no-shows and same day cancellations--for Medicaid patients. The study population consists of West Philadelphia residents who are established patients at two of the Penn Medicine Primary Care Practices within the University of Pennsylvania Health System. The study subjects are allocated into the intervention or control arm using a pseudorandomization approach - those receiving an appointment reminder on an even calendar day are in the intervention arm and odd calendar day calls are in the control arm. Secondary outcomes include the time of arrival to the clinics relative to actual appointment time (both arms), prospective utilization of acute care settings (both arms), prospective utilization of primary care (both arms), and description of programmatic metrics in the intervention arm (travel time, misuse, and costs). The investigators will assess the patient experience after each ride using a telephone-based survey and in-depth interviews. All adults with established primary care at the Penn Medicine Clinics, who have Medicaid, and do not require wheelchair accessible rides will be eligible for the rideshare service. The investigators hypothesize that individuals offered a rideshare-based transportation service will have a decreased proportion of missed appointments and same day cancellations as those not offered the service.